The Heart of Development: OT’s Role in Nurturing Social - Emotional Skills

Social emotional development is critical in a child’s journey as they learn to regulate their bodies, emotions, and experiences in their day-to-day world. Social-emotional development can be defined as the process of learning to understand and manage one’s own emotions, develop positive relationships, and interact effectively with others. These skills are important for a child not only to understand themselves but also to express their needs to others while building and maintaining healthy relationships.

Within this realm, self-regulation plays a large role in a child’s development. Self-regulation is the capacity to manage one’s behavior, thoughts, and emotions including impulse control and managing frustration. These skills, along with the social components of forming and maintaining positive relationships, directly impact a child’s ability to participate in daily occupations such as play, learning, and self-care. When children experience poor regulation or social-emotional balance, they may withdraw from others, become easily frustrated, or have trouble joining play and classroom routines. Occupational therapists (OTs) play a vital role in supporting this area of development through developmentally appropriate, play-based activities that strengthen both social and emotional skills.

Understanding Social–Emotional Development

It’s important to understand the key components of social-emotional development, which include emotional regulation and expression, social interaction and relationship building, empathy and perspective-taking, and a sense of self and confidence. Developmental milestones directly related to social-emotional growth from infancy through childhood include bonding, sharing, turn-taking, and coping with frustration. These milestones help children build healthy relationships with family and peers, develop social play skills, and learn to manage emotions during everyday experiences.

When children have delays in meeting these milestones, it may appear as frequent tantrums, difficulty with transitions, or avoidance of peers. During emotional outbursts, many children find it hard to calm down, and their reactions may seem extreme compared to the cause. These challenges can make it difficult to participate in play, such as giving up easily when their block tower falls, limiting their ability to persevere through tasks. They may struggle to connect with peers, leading to social avoidance or even peers avoiding them. Difficulties with emotional regulation can also interfere with learning and attention, as more time is spent trying to calm the body rather than engaging in learning activities. This can spill into daily routines, making transitions like getting dressed or cleaning up take much longer than expected and adding stress to the family’s day.

Occupational Therapy’s Lens on Social-Emotional Development

Occupational therapists assess the whole child considering how sensory, motor, cognitive, and emotional systems interact to support participation. OTs look beyond behavior to identify the underlying causes of challenges. For instance, a child who has meltdowns during toothbrushing may not be “defiant,” but rather responding to sensory sensitivities caused by the texture or sound of the toothbrush. Similarly, a child who avoids circle time might be overwhelmed by noise or proximity to peers, leading to dysregulation rather than disinterest.

By identifying these sensory or environmental factors, OTs create strategies and activities to support regulation. They may use deep pressure (like hand squeezes or weighted blankets) or vestibular input (like gentle swinging) to help organize the child’s nervous system. These interventions are woven into meaningful, occupation-based activities such as play, daily routines, and relationships with caregivers. Through these experiences, children build self-awareness, emotional control, and social confidence in natural and motivating ways.

Common OT Approaches and Strategies

When addressing social-emotional needs, occupational therapy focuses on strategies that can be carried over into the home and community. OTs often use co-regulation, teaching caregivers how to model calming strategies, label emotions, and provide comfort when a child is overwhelmed. This helps children learn through observation and imitation, developing emotional awareness in a safe, connected way.

Sensory regulation strategies are also common. These might include deep pressure (like “bear hugs” or heavy work), movement breaks (like jumping or pushing a weighted bin), or the use of fidget tools to support emotional control and focus. These activities help children learn what their bodies need to feel calm and alert, which is essential for engagement and participation.

During play, OTs use games and social interactions to build skills like turn-taking, sharing, and cooperation. These activities not only support social understanding but also strengthen frustration tolerance and flexibility. Through guided play, children learn how to navigate wins and losses, share materials, and join group activities, all skills that transfer into friendships and classroom routines.

In everyday life, predictable routines are another cornerstone of emotional regulation. OTs often help families create structured routines for mornings, meals, and bedtime to promote a sense of safety and stability. Predictable patterns help children know what to expect, reducing anxiety and improving cooperation during transitions.

The Connection Between Regulation, Engagement, and Participation

Regulation, engagement, and participation are deeply connected. When a child is regulated, meaning their body and emotions are calm and organized, they are better able to focus, connect, and learn. This state of regulation allows for meaningful engagement in play, social interactions, and learning experiences. As engagement increases, so does participation across environments, supporting the child’s growth and overall well-being.

Conclusion

Social-emotional development is at the heart of everything a child does. From forming relationships to participating in daily routines, these skills lay the foundation for lifelong learning and connection. Occupational therapists play a key role in supporting this growth by addressing sensory, emotional, and environmental needs in ways that are meaningful and playful. Through collaboration with families and caregivers, OTs help children build confidence, resilience, and the self-regulation skills they need to thrive in every area of life.